ACC MIPS Improvement Activities
The following ACC National Quality Campaigns and clinical tools count as Improvement Activities under the Merit-Based Incentive Payment System (MIPS) – one of two ways clinicians can participate in the Centers for Medicare and Medicaid Services' Quality Payment Program.
High-Weight Improvement Activities
- Patient Navigator Program: Focus MI (Chest Pain-MI Registry) (MIPS Activity ID: IA_CC_17)
- Reduce the Risk: PCI Bleed (CathPCI Registry) (MIPS Activity ID: IA_PSPA_30)
Medium-Weight Improvement Activities
- Clinical Quality Coach App (CathPCI Registry) (MIPS Activity ID: IA_PSPA_2)
How Improvement Activities Work
Clinicians must complete up to four Improvement Activities for a minimum of 90 days. CMS has assigned high or medium "weights" to Improvement Activities, allowing clinicians the option of completing two high-weight, four medium-weight, or a combo of one high-weight and two medium-weight activities to receive MIPS credit. Note: Groups with fewer than 15 participants or clinicians in a rural or health professional shortage area need to only complete up to two activities for a minimum of 90 days.
How to Claim Participation in ACC Improvement Activities
*Note: Oct. 1, 2019 is the last date to BEGIN participation in these programs to meet the 90-day minimum.
- Check your MIPS participation status by entering your 10-digit National Provider Identifier (NPI) number.
- Use the NCDR Participant Directory to find out if your associated hospital is participating in a relevant registry.
- If YES, the hospital Registry Site Manager can verify whether the hospital is also participating in Patient Navigator Program: Focus MI and/or Reduce the Risk: PCI Bleed. If using the Clinical Quality Coach App, clinicians can attest on their own.
If NO, you can request that your hospital opt-in to participate in one or both programs. Opt-in is free and easy instructions are available on the respective campaign websites.
- Clinicians associated with Patient Navigator Program: Focus MI and/or Reduce the Risk: PCI Bleed will need to report their participation through their MIPS reporting mechanism (i.e., attestation, Qualified Clinical Data Registry [QCDR], Qualified Registry, EHR, CMS Web Interface) using the associated MIPS Activity ID. Clinicians can complete a short attestation form and receive a certificate of participation directly from the Patient Navigator Program: Focus MI website and the Reduce the Risk: PCI Bleed website . While documentation of an activity is not required to report participation, CMS urges participants to maintain documentation on file for six years.
Note: The ACC will NOT submit data on behalf of clinicians participating in these programs. The last date to begin participation is Oct. 1, 2019!
For Hospital Administrators
- If you haven't already, opt-in to participate in the Patient Navigator Program: Focus MI (Chest Pain-MI Registry) and/or the Reduce the Risk: PCI Bleed (CathPCI Registry). Instructions are available on the campaign websites. You will need your NCDR user name and password.
- Let affiliated cardiovascular clinicians know your hospital is participating in one or both ACC programs and that they can be used towards Improvement Activity credit under the Merit-Based Incentive Payment System (MIPS). (Go here, for a sample email.) CathPCI-participating hospitals should also ensure affiliated clinicians know about the Clinical Quality Coach App as another MIPS Improvement Activity option.
- Eligible clinicians will need to attest to their participation in the activity as part of the 2018 reporting year. Clinicians can complete a short attestation form and receive a certificate of participation directly from the Patient Navigator Program: Focus MI website and the Reduce the Risk: PCI Bleed website.